scholarly journals An Objective Metric of Individual Health And Aging For Population Surveys

2021 ◽  
Author(s):  
Qing Li ◽  
Véronique Legault ◽  
Vincent-Daniel Girard ◽  
Luigi Ferrucci ◽  
Linda P. Fried ◽  
...  
Keyword(s):  
Health Status ◽  
Health Outcomes ◽  
Allostatic Load ◽  
Individual Health ◽  
Clinical Biomarkers ◽  
Physiological Dysregulation ◽  
Objective Metrics ◽  
Different Populations ◽  
Self Assessed Health ◽  
Better Than

Abstract Background: Generalized, biomarker-based metrics of health status have numerous applications in fields ranging from sociology and economics to clinical research. We recently proposed a novel metric of health status based on physiological dysregulation measured as a Mahalanobis distance (DM) among clinical biomarkers. While DM was not particularly sensitive to the choice of biomarkers, it required calibration when used in different populations, making it difficult to compare findings across studies. To facilitate its use, here we aimed to identify and validate a standard version of DM that would be highly stable across populations, while using fewer biomarkers drawn exclusively from common blood panels. Methods: Using three datasets, we identified nine-biomarker (DM9) and seventeen-biomarker (DM17) versions of DM, choosing biomarkers based on their consistent levels across populations. We validated them in a fourth dataset. We assessed DM stability within and across populations by looking at correlations of DM versions calibrated using different populations or their demographic subsets. We used regression models to compare these standard DM versions to allostatic load and self-assessed health in their association with diverse health outcomes. Results: DM9 and DM17 were highly stable across population subsets (mean r = 0.96 and 0.95, respectively) and across populations (mean r = 0.94 for both). Performance predicting health outcomes was competitive with allostatic load and self-assessed health, though performance of these markers were somewhat variable for different health outcomes. Conclusions: Both DM9 and DM17 are highly stable within and across populations, supporting their use as objective metrics of health status. DM17 performs slightly better than DM9 and at least as well as other comparable metrics, but requires more biomarkers. The metrics we propose here are easy to measure with data that are available in a wide array of panel, cohort, and clinical studies.

Depression and its Somatic Consequences: Allostatic Load as the Connecting Link

2017 ◽  
Vol 41 (S1) ◽  
pp. S62-S62
Author(s):  
B. Penninx
Keyword(s):  
Health Outcomes ◽  
Psychiatric Disorders ◽  
Allostatic Load ◽  
Cellular Aging ◽  
Health Consequences ◽  
Somatic Health ◽  
Depressed Patients ◽  
Physiological Dysregulation ◽  
Increased Risk ◽  
The Impact

Stress-related psychiatric disorders, such as depressive and anxiety disorders, have been associated with increased risk of overall mortality as well as with the onset of various aging-related somatic diseases. In addition to unhealthy lifestyles and poorer (self) care, various stress-related physiological processes likely contribute to these detrimental health consequences of psychiatric disorders. Considering the fact that the impact of stress-related disorders is visible on many different somatic health outcomes, it is unlikely that contributing biological systems are very specific. In fact, it is likely that multiple dysregulations of stress systems, including the immune, HPA-axis and autonomic nervous systems, but also various general proteomic or metabolomic pathways are involved. The concept of Allostatic Load (AL) emphasizes the presence of a multi-system physiological dysregulation.In this talk I will summarize what the evidence is for somatic health consequences of psychiatric conditions, with depression as an important example. Subsequently, I will provide an overview of the various stress systems that are dysregulated in depressed patients. In addition, I will provide empirical data from the Netherlands Study of Depression and Anxiety (n = 2981) that illustrate that there is evidence that depressed patients are especially at risk for a dysregulation in multiple physiological stress systems. I will also illustrate how such a state of AL can impact on basis cellular aging indicators like telomere length and epigenetic age.In sum, this talk will highlight the current state-of-evidence for an association between depressions with the onset of many adverse somatic health outcomes, and will provide insight into the contributing role of a multisystem physiological dysregulation.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals The Utility of Red Cell Distribution Width as a Parameter for Calculating Indices of Allostatic Load

2016 ◽  
Author(s):  
Ghalib A Bello ◽  
Gerard G Dumancas
Keyword(s):  
Health Status ◽  
Allostatic Load ◽  
Goodness Of Fit ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Cell Distribution ◽  
Strong Correlations ◽  
Distribution Width ◽  
Clinical Biomarkers ◽  
Current Formulation

AbstractBackgroundAllostatic Load is a construct used to quantify the cumulative burden of exposure to stressors that, over the course of an individual’s life, exert a toll on the body’s physiological functions, increasing risks of various chronic ailments and conditions. Studies attempting to quantify allostatic load have used a variety of clinical biomarkers representing primary and secondary mediators. In this study, we demonstrate the value of including red blood cell distribution width (RDW) among the panel of clinical parameters used to calculate allostatic load.MethodsWe develop a novel formulation of allostatic load using RDW and other standard biomarkers. This index is computed using clinical laboratory data from the NHANES study. The predictive validity of the new index for tertiary outcomes (all-cause mortality and physician-assessed health status) is compared to that of the current formulation using Harrell’s C index, ROC analysis and regression-based goodness-of-fit measures.ResultsInclusion of RDW as an allostatic load biomarker yields a significantly improved index. It demonstrates a superior ability to predict mortality, health status and biological age than the standard formulation currently in use.ConclusionRDW has shown strong correlations with mortality and a broad spectrum of diseases. A review of the existing literature on allostatic load reveals its underutilization in this area, despite being a standard component of blood count panels. This study is the first to demonstrate its usefulness as a potential allostatic load biomarker.

scholarly journals Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data

2014 ◽  
Vol 2 (1) ◽  
pp. 1-90 ◽  
Author(s):  
Andrew Street ◽  
Nils Gutacker ◽  
Chris Bojke ◽  
Nancy Devlin ◽  
Silvio Daidone
Keyword(s):  
Health Status ◽  
Health Outcomes ◽  
Knee Replacement ◽  
Resource Use ◽  
Patient Reported Outcomes ◽  
Hospital Performance ◽  
Patient Reported ◽  
The Empirical Analysis ◽  
Unexplained Variation ◽  
Better Than

BackgroundIt is important that NHS resources are used to their full extent, but efforts to reduce costs may have an adverse effect on patient outcomes. Our research is designed to provide a better understanding of the inter-relationship between costs and health outcomes among NHS providers (hospitals) for common surgical procedures.ObjectivesIn England, patient-reported outcomes measures (PROMs) are collected from patients undergoing one of four elective procedures: unilateral hip replacement, unilateral knee replacement, groin hernia repair and varicose vein surgery. We identify variation in patient-reported outcomes (PROs) across hospitals, assess the relationship between the cost and outcomes among NHS hospitals for these procedures, and determine the extent to which variations in outcomes and costs are due to differences in hospital performance.Data sourcesWe link Hospital Episode Statistics (HES) data with reference cost data and PROM data for patients having the four treatments between April 2009 and March 2010.MethodsThe first part of the empirical analysis focuses on variation in different dimensions of self-reported health status. We argue that each of the EuroQol-5D questionnaire (EQ-5D; European Quality of Life-5 Dimensions) dimensions should be assessed separately. Our graphical summary of the differential impact that hospitals have on PROs indicates the probability of reporting a given health outcome and shows how these probabilities vary across EQ–5D dimensions and hospitals. The second part of the empirical analysis focuses on the performance of hospitals and the inter-relationship between PROs and resource use.ResultsWe find that poorer post-treatment health status is associated with lower initial health status, higher weighted Charlson score, more diagnoses and lower socioeconomic status. We find significantly unexplained variation among hospitals in outcomes for patients undergoing hip replacement, knee replacement or varicose vein surgery, but not for hernia patients. For all four treatments we find significant unexplained variation in resource use among hospitals, whether measured by cost of treatment or length of stay. This suggests that hospitals can improve their utilisation of resources.LimitationsOur analyses are based on the HES. If data are missing from the medical record, or extracted and coded inaccurately, HES will contain errors. Hospitals should minimise these errors. Our study suffers from a large number of missing data, mainly because some hospitals were better than others at administering the baseline survey.ConclusionsThere is no general evidence that hospitals with lower resource use have worse health outcomes. There is a significant positive correlation for varicose veins, but this is sensitive to the choice of resource use and PRO measures. For hip and knee replacement the correlation is either insignificant or negative (depending on the resource use and PRO measures), implying that promoting health outcomes and controlling costs are not contradictory objectives. Indeed, we are able to identify hospitals with better than expected outcomes where resource use is below average. Future research should address how to handle missing data, evaluate hospital performance within the broader health economy, communicate PROMs to prospective patients, evaluate the impact of PROMs on patient choice and provider behaviour and evaluate PROMs for people with chronic conditions.FundingThe National Institute for Health Research Health Service and Delivery Research programme.

scholarly journals Health Lifestyles and Their Influence on Chinese Oldest-old’s Health Outcomes —Evidence From a Latent Class Analysis

2020 ◽  
Author(s):  
Li Zhang ◽  
Xiangyang Bi ◽  
Zhihong Ding
Keyword(s):  
Health Status ◽  
Health Behaviors ◽  
Health Outcomes ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Oldest Old ◽  
Functional Independence ◽  
Class Analysis ◽  
Health Lifestyles ◽  
Individual Health

Abstract BackgroundA strong association between individual health behaviors and health outcomes has been emphasized by previous analyses. However, how individual health behaviors can be classified into health lifestyles and the manner in which health lifestyles have impacted Chinese oldest-old’s health status are largely unknown.MethodsAnalyzing the 2014 Chinese Longitudinal Healthy Longevity Survey (CLHLS), latent class analysis was applied to identify predominant health lifestyles among Chinese oldest-old aged 85 to 105.ResultsFour distinct classes representing health lifestyles emerged. Health lifestyles were found to be strongly associated with Chinese oldest-old’s health outcomes which were measured by self-rated health, functional independence, cognitive function and chronic diseases, even after controlling for demographic features as well as individual and parental socioeconomic disadvantage. Findings also showed a convergence of health disparities caused by demographic and SES characteristics in very old age.ConclusionsChinese oldest-old showed four predominant health lifestyles with only 21.9% of the sample had consistently healthy lifestyle behaviors. The significant influence of health lifestyles on health remained after age 85, .highlighting the importance of promoting health lifestyles to advance the oldest-old’s health status.

scholarly journals The impact of microfinance programmes on access to health care, knowledge to health indicators and health status among women in Moshi, Tanzania

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Christopher D. Mtamakaya ◽  
Joachim Kessy ◽  
Damian Jeremia ◽  
Sia Msuya ◽  
Babill Stray-Pedersen
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Health Status ◽  
Health Outcomes ◽  
Access To Health Care ◽  
Health Indicators ◽  
Program Participation ◽  
Access To Health ◽  
Programme Participation ◽  
Self Assessed Health

Background:  Microfinance Institutions (MFI) award small loans and women are the primary target. Whilst much literature has explored and acknowledged its impact on poverty alleviation and gender equality few studies have examined whether the added income also improves health outcomes to program clients. This study examined the association between participation in MFI programmes and wellbeing of clients and their family members via social determinants of health in Moshi, Tanzania.Methods: Cross-sectional data among non-elderly women were collected between October and December 2011. Multistage random sampling technique was employed to obtain study participants. The primary predictor variable was participation in MFI programs while the outcome measures were: odds of facing exclusion to health care, knowledge to health indicators related to health promotion, and self-assessed health status. A questionnaire was used to collect extensive data on demographic and socioeconomic information of the study participants.Results: A total of 900 women participated in the study. Program participation was found to be associated with increasing age (p<0.001), increasing number of living children (p<0.002) and level of income (p<0.001).  We found no association between program participation and access to health care, knowledge to health indicators related to health promotion and self-assessed health status. Only one out of seven indicators (14.2%) was significantly associated with MFI participation and access to health care. Two out of six (33.3%) health indicators showed association to MFI programme participation, while only 3 out of 15 (20%) dimensions measured in self-assessed health status showed significant association to MFI programme participation.Conclusion: These findings indicate that MFI programme participation is not associated with improved health outcomes of clients and their family members in Moshi. Strategies are needed to enhance the health-promoting capacity of MFI programmes in Moshi as shown elsewhere.

scholarly journals Working conditions and health status of 6,317 front line public health workers across five provinces in China during the COVID-19 epidemic: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Li ◽  
Jingdong Xu ◽  
Huan Zhou ◽  
Hua You ◽  
Xiaohui Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Status ◽  
Health Outcomes ◽  
Working Conditions ◽  
Health Workers ◽  
Front Line ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Public Health Workers

ABSTRACT Background Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic. Methods Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). Conclusions Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.

scholarly journals Performance of Seven Consumer Sleep-Tracking Devices Compared with Polysomnography

SLEEP ◽  
2020 ◽  
Author(s):  
Evan D Chinoy ◽  
Joseph A Cuellar ◽  
Kirbie E Huwa ◽  
Jason T Jameson ◽  
Catherine H Watson ◽  
...  
Keyword(s):  
Performance Measures ◽  
Gold Standard ◽  
High Performance ◽  
Sleep Stage ◽  
Sleep Laboratory ◽  
Sleep Assessment ◽  
Sleep Condition ◽  
Different Populations ◽  
Tracking Devices ◽  
Better Than

Abstract Study Objectives Consumer sleep-tracking devices are widely used and becoming more technologically advanced, creating strong interest from researchers and clinicians for their possible use as alternatives to standard actigraphy. We therefore tested the performance of many of the latest consumer sleep-tracking devices, alongside actigraphy, versus the gold-standard sleep assessment technique, polysomnography (PSG). Methods In total, 34 healthy young adults (22 women; 28.1 ± 3.9 years, mean ± SD) were tested on three consecutive nights (including a disrupted sleep condition) in a sleep laboratory with PSG, along with actigraphy (Philips Respironics Actiwatch 2) and a subset of consumer sleep-tracking devices. Altogether, four wearable (Fatigue Science Readiband, Fitbit Alta HR, Garmin Fenix 5S, Garmin Vivosmart 3) and three non-wearable (EarlySense Live, ResMed S+, SleepScore Max) devices were tested. Sleep/wake summary and epoch-by-epoch agreement measures were compared with PSG. Results Most devices (Fatigue Science Readiband, Fitbit Alta HR, EarlySense Live, ResMed S+, SleepScore Max) performed as well as or better than actigraphy on sleep/wake performance measures, while the Garmin devices performed worse. Overall, epoch-by-epoch sensitivity was high (all ≥0.93), specificity was low-to-medium (0.18-0.54), sleep stage comparisons were mixed, and devices tended to perform worse on nights with poorer/disrupted sleep. Conclusions Consumer sleep-tracking devices exhibited high performance in detecting sleep, and most performed equivalent to (or better than) actigraphy in detecting wake. Device sleep stage assessments were inconsistent. Findings indicate that many newer sleep-tracking devices demonstrate promising performance for tracking sleep and wake. Devices should be tested in different populations and settings to further examine their wider validity and utility.

Understanding Exercise Challenges and Barriers for Older Adults with Mobility Disabilities

2020 ◽  
Vol 64 (1) ◽  
pp. 1297-1301
Author(s):  
Qiong Nie ◽  
Lyndsie M. Koon ◽  
Madina Khamzina ◽  
Wendy A. Rogers
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Older People ◽  
Health Outcomes ◽  
Quantitative Evaluation ◽  
Exercise Barriers ◽  
Depth Interview ◽  
Physical Limitations ◽  
Barriers And Challenges ◽  
Depth Interviews

Interventions to address exercise challenges in older people have been the focus of recent research, given the importance of exercise for health outcomes. However, exercise challenges for older adults with mobility disabilities have received little attention. We investigated participation of exercise among older adults with mobility disabilities to understand exercise barriers and challenges experienced by this population. We conducted a needs assessment using two archival datasets: a quantitative survey with 1,137 respondents and a qualitative in-depth interview with 23 participants. The quantitative evaluation revealed low participation of walking and less engagement of vigorous activities, and significant correlates of health status and lack of energy with vigorous activities. The in-depth interviews showed exercise challenges were attributed to difficulties with physical limitations, accessibility, and environmental limitations. Individuals with mobility disabilities may face unique challenges and barriers, affordable and effective supports to promote exercise engagement for them should be adapted to such needs.

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